Syncope Time Frames for Adverse Events after Emergency Department Presentation: An Individual Patient Data Meta-Analysis
<i>Background and Objectives</i>: Knowledge of the incidence and time frames of the adverse events of patients presenting syncope at the ED is essential for developing effective management strategies. The aim of the present study was to perform a meta-analysis of the incidence and time f...
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MDPI AG
2021
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oai:doaj.org-article:7649e4c7c2cb47f08e3090db7fbfc6d52021-11-25T18:18:50ZSyncope Time Frames for Adverse Events after Emergency Department Presentation: An Individual Patient Data Meta-Analysis10.3390/medicina571112351648-91441010-660Xhttps://doaj.org/article/7649e4c7c2cb47f08e3090db7fbfc6d52021-11-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1235https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144<i>Background and Objectives</i>: Knowledge of the incidence and time frames of the adverse events of patients presenting syncope at the ED is essential for developing effective management strategies. The aim of the present study was to perform a meta-analysis of the incidence and time frames of adverse events of syncope patients. <i>Materials and Methods</i>: We combined individual patients’ data from prospective observational studies including adult patients who presented syncope at the ED. We assessed the pooled rate of adverse events at 24 h, 72 h, 7–10 days, 1 month and 1 year after ED evaluation. <i>Results</i>: We included nine studies that enrolled 12,269 patients. The mean age varied between 53 and 73 years, with 42% to 57% females. The pooled rate of adverse events was 5.1% (95% CI 3.4% to 7.7%) at 24 h, 7.0% (95% CI 4.9% to 9.9%) at 72 h, 8.4% (95% CI 6.2% to 11.3%) at 7–10 days, 10.3% (95% CI 7.8% to 13.3%) at 1 month and 21.3% (95% CI 15.8% to 28.0%) at 1 year. The pooled death rate was 0.2% (95% CI 0.1% to 0.5%) at 24 h, 0.3% (95% CI 0.1% to 0.7%) at 72 h, 0.5% (95% CI 0.3% to 0.9%) at 7–10 days, 1% (95% CI 0.6% to 1.7%) at 1 month and 5.9% (95% CI 4.5% to 7.7%) at 1 year. The most common adverse event was arrhythmia, for which its rate was 3.1% (95% CI 2.0% to 4.9%) at 24 h, 4.8% (95% CI 3.5% to 6.7%) at 72 h, 5.8% (95% CI 4.2% to 7.9%) at 7–10 days, 6.9% (95% CI 5.3% to 9.1%) at 1 month and 9.9% (95% CI 5.5% to 17) at 1 year. Ventricular arrhythmia was rare. <i>Conclusions</i>: The risk of death or life-threatening adverse event is rare in patients presenting syncope at the ED. The most common adverse events are brady and supraventricular arrhythmias, which occur during the first 3 days. Prolonged ECG monitoring in the ED in a short stay unit with ECG monitoring facilities may, therefore, be beneficial.Ludovico FurlanLucia TrombettaGiovanni CasazzaFranca DipaolaRaffaello FurlanChiara MartaFilippo NumerosoJordi Pérez-RodonJames V. QuinnMatthew J. ReedRobert S. SheldonWin-Kuang ShenBenjamin C. SunVenkatesh ThiruganasambandamoorthyAndrea UngarGiorgio CostantinoMonica SolbiatiMDPI AGarticlesyncopeemergency departmentoutcomesadverse eventsarrhythmiamortalityMedicine (General)R5-920ENMedicina, Vol 57, Iss 1235, p 1235 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
syncope emergency department outcomes adverse events arrhythmia mortality Medicine (General) R5-920 |
| spellingShingle |
syncope emergency department outcomes adverse events arrhythmia mortality Medicine (General) R5-920 Ludovico Furlan Lucia Trombetta Giovanni Casazza Franca Dipaola Raffaello Furlan Chiara Marta Filippo Numeroso Jordi Pérez-Rodon James V. Quinn Matthew J. Reed Robert S. Sheldon Win-Kuang Shen Benjamin C. Sun Venkatesh Thiruganasambandamoorthy Andrea Ungar Giorgio Costantino Monica Solbiati Syncope Time Frames for Adverse Events after Emergency Department Presentation: An Individual Patient Data Meta-Analysis |
| description |
<i>Background and Objectives</i>: Knowledge of the incidence and time frames of the adverse events of patients presenting syncope at the ED is essential for developing effective management strategies. The aim of the present study was to perform a meta-analysis of the incidence and time frames of adverse events of syncope patients. <i>Materials and Methods</i>: We combined individual patients’ data from prospective observational studies including adult patients who presented syncope at the ED. We assessed the pooled rate of adverse events at 24 h, 72 h, 7–10 days, 1 month and 1 year after ED evaluation. <i>Results</i>: We included nine studies that enrolled 12,269 patients. The mean age varied between 53 and 73 years, with 42% to 57% females. The pooled rate of adverse events was 5.1% (95% CI 3.4% to 7.7%) at 24 h, 7.0% (95% CI 4.9% to 9.9%) at 72 h, 8.4% (95% CI 6.2% to 11.3%) at 7–10 days, 10.3% (95% CI 7.8% to 13.3%) at 1 month and 21.3% (95% CI 15.8% to 28.0%) at 1 year. The pooled death rate was 0.2% (95% CI 0.1% to 0.5%) at 24 h, 0.3% (95% CI 0.1% to 0.7%) at 72 h, 0.5% (95% CI 0.3% to 0.9%) at 7–10 days, 1% (95% CI 0.6% to 1.7%) at 1 month and 5.9% (95% CI 4.5% to 7.7%) at 1 year. The most common adverse event was arrhythmia, for which its rate was 3.1% (95% CI 2.0% to 4.9%) at 24 h, 4.8% (95% CI 3.5% to 6.7%) at 72 h, 5.8% (95% CI 4.2% to 7.9%) at 7–10 days, 6.9% (95% CI 5.3% to 9.1%) at 1 month and 9.9% (95% CI 5.5% to 17) at 1 year. Ventricular arrhythmia was rare. <i>Conclusions</i>: The risk of death or life-threatening adverse event is rare in patients presenting syncope at the ED. The most common adverse events are brady and supraventricular arrhythmias, which occur during the first 3 days. Prolonged ECG monitoring in the ED in a short stay unit with ECG monitoring facilities may, therefore, be beneficial. |
| format |
article |
| author |
Ludovico Furlan Lucia Trombetta Giovanni Casazza Franca Dipaola Raffaello Furlan Chiara Marta Filippo Numeroso Jordi Pérez-Rodon James V. Quinn Matthew J. Reed Robert S. Sheldon Win-Kuang Shen Benjamin C. Sun Venkatesh Thiruganasambandamoorthy Andrea Ungar Giorgio Costantino Monica Solbiati |
| author_facet |
Ludovico Furlan Lucia Trombetta Giovanni Casazza Franca Dipaola Raffaello Furlan Chiara Marta Filippo Numeroso Jordi Pérez-Rodon James V. Quinn Matthew J. Reed Robert S. Sheldon Win-Kuang Shen Benjamin C. Sun Venkatesh Thiruganasambandamoorthy Andrea Ungar Giorgio Costantino Monica Solbiati |
| author_sort |
Ludovico Furlan |
| title |
Syncope Time Frames for Adverse Events after Emergency Department Presentation: An Individual Patient Data Meta-Analysis |
| title_short |
Syncope Time Frames for Adverse Events after Emergency Department Presentation: An Individual Patient Data Meta-Analysis |
| title_full |
Syncope Time Frames for Adverse Events after Emergency Department Presentation: An Individual Patient Data Meta-Analysis |
| title_fullStr |
Syncope Time Frames for Adverse Events after Emergency Department Presentation: An Individual Patient Data Meta-Analysis |
| title_full_unstemmed |
Syncope Time Frames for Adverse Events after Emergency Department Presentation: An Individual Patient Data Meta-Analysis |
| title_sort |
syncope time frames for adverse events after emergency department presentation: an individual patient data meta-analysis |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/7649e4c7c2cb47f08e3090db7fbfc6d5 |
| work_keys_str_mv |
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| _version_ |
1718411328021856256 |